Running with Dysmenorrhea

Disclaimer: I am not a medical professional. If you suffer from painful periods or chronic pelvic pain, please consult a medical professional. The information in this post stems personal experience. Every case of dysmenorrhea is individual and therefore manifests differently. Ultimately, you have to do what is best for you and your body.

I hunched over in pain, trying to hold back the urge to either vomit or faint. I felt as if a knife had plunged into the right side of my pelvis and was slowly twisting. My clammy skin and slumped posture caused my classmates to gaze at me in concern and confusion. I reasoned to myself that if I could get through this class, I could skip my run and go directly home to nap. Or maybe I should have run before to temporarily numb the pain with endorphins? Did I bring enough Midol to make it through a run? Unfortunately, this wasn’t an out of the ordinary experience for me – and perhaps you’ve experienced painful periods as well.

The medical term for painful periods is dysmenorrhea. Dysmenorrhea includes pelvic pain, abdominal cramping, lower back pain, hip pain, headaches, nausea, and lightheadedness during menstruation. For some women, GI distress and diarrhea can accompany the pain, as can mood swings and heavy bleeding. These aren’t merely minor nuisance of PMS cramps. Advil and Midol only make a dent in the severity of the pain. Basic activities – from attending work or school to normal daily runs – are disrupted.

We read articles discussing amenorrhea (loss of period) from running, which is something female runners must be aware of and prevent. We also see more knowledge is being shared about how to train around a normal menstrual cycle. But what about when you suffer from dysmenorrhea? I often felt like I couldn’t find answers and would be frustrated at the lack of information.

I suffered from dysmenorrhea from when my period started in middle school. My periods were irregular, unpredictable, and painful. I’d suffer from both GI distress and pelvic pain so much that I’d contemplate staying home from school, which was not normal for a school-loving bookworm such as myself. The symptoms worsened with each year.

Then at 17, I lost my period without any change in exercise, eating, or weight – I wasn’t even running yet. I was diagnosed with non-insulin resistant lean PCOS with low progesterone, swallowed large progesterone pills to force my body to have a period, and then was put on medication to balance my hormones.

Yet the pain continued through my late teens and 20s, even though my medication was so I only got 3-4 periods per year. Mood swings, stabbing pain in my pelvis, low back pain, and a general sense of fatigue would render me feeling like a shell of myself for several days. I have a get-it-done mentality, so I persisted in class, work, and training as best as I could even with the pain.

Eventually, my doctors suspected based on my symptoms and family history that I had endometriosis, a condition in which uterine lining grows and attaches outside of the uterus, thus causing painful periods. While they didn’t confirm it via laparoscopic surgery, they adjusted my medication to prevent both pain and symptoms from worsening. The decision wasn’t based on running – it was based on health and quality of life – but it certainly did help with running. I still have bouts of pelvic pain, but nothing as severe or frequent.

(Edited to add: In December of 2017, I had a laparoscopy that was negative for endometriosis and removed two adhesions that were causing GI issues and chronic pelvic pain. My doctor now suspects that my painful periods are related to hormonal issues and long, irregular cycles.)

My dysmenorrhea was a disruption to my otherwise active lifestyle, even when I only had 3-4 periods per year. I wanted to spend all day in bed and I struggled to motivate myself. I stuck to the treadmill to have a bathroom nearby and would drug myself with Advil and Midol first (which wasn’t always the best idea for my stomach). But I needed to run. Running reduced the pain, even if just temporarily, leveled my mood swings, and kept me from feeling like my body was broken.

Painful periods are a reality for many women, and the causes can range from the individual person to a chronic condition such as endometriosis. The severity can range as well, but what marks dysmenorrhea as different from normal menstrual cramps is that the pain is significant enough to disrupt your normal routine. Running can seem near impossible at times when you have dysmenorrhea, but most female runners find that the movement and endorphins reduce the pain, even if just for a few hours. The following tips are based on what worked for me when running with dysmenorrhea.

Please do know that this is non-medical advice from the perspective of a coach and runner who experienced dysmenorrhea. This is training advice, not advice on how to treat dysmenorrhea as a whole. Every case of dysmenorrhea is individual and will be treated different medically – so how I am treated medically may be very different than how you manage the pain.

Talk to Your Doctor

There are two different types of dysmenorrhea: primary (no underlying cause) and secondary (underlying cause). You may just get bad cramps as part of PMS and menstruation – or you may be suffering from endometriosis, pelvic inflammatory disease, or another health issue. I honestly thought painful periods were normal until I talked to my doctor about them.

Talk to your doctor so they can help you and check for underlying causes. If they determine that it is primary dysmenorrhea, then you can have peace of mind and learn how to alleviate the pain. If they find an underlying cause, then you can discuss treatment options to ensure that your overall health and fertility do not suffer.

Properly Warm Up Before Your Run

Going from curled up in a ball on the sofa to trying to run isn’t conducive to a good run, regardless of whether or not you are on your period. A warm up will improve mobility in your joints, increase blood flow to your muscles, and mentally help you transition from rest to running. The light movement may also help reduce the pain of cramps before you start to run. Warm up with few minutes of easy walking followed by some dynamic stretches.

Treat Your Period as Cutback Week

Cutback weeks occur every 3-4 weeks when training for a race. Mileage, intensity, or both are reduced in order to let the body recover so that it can adapt and you can continue to train hard and improve.

Women with normal periods will find cutback weeks are ideal before their periods. During your luteal phase (from ovulation to right before menstruation, the change in hormones make female runners more sensitive to heat and more prone to dehydration or electrolyte imbalance. Once menstruation begins, hormone levels drop and the body is better able to regulate the core temperature and balance fluids.

However, for women with dysmenorrhea, the week encompassing the days before the period through the first few days of menstruation are ideal for a cutback week. Despite the drop in hormones, the pain of dysmenorrhea and the possible accompanying GI distress can make running difficult. Even if you do run, you likely won’t feel up to running a hard interval workout. By reducing mileage, intensity, and even frequency, you can both aid your body in recovery from training while managing your pain. Training should fit your life – including your cycle.

Within that cutback week, adjust the training days themselves to accommodate how you feel. You may find that the severity of pain requires rest of the first day of your period, and then you can do easy runs the remainder of the week – so plan accordingly and be rearrange your training schedule in that week. If you have a running coach, communicate to her the need to adjust training that week so she can help you.

Emphasize Recovery

Particularly if you have secondary dysmenorrhea from endometriosis or a similar inflammatory condition, high levels of inflammation and stress can make dysmenorrhea worse. My worst bouts of dysmenorrhea coincided with applying to grad schools and other stressful times in life. You also battle fatigue during this time, which can hinder recovery from a hard run. Scaling back your training will help, as you emphasizing recovery.

Be sure to get enough sleep (you may find you need even more during your period). Choose anti-inflammatory foods such as blueberries and tart cherry juice and be sure to eat within that vital 30-60 minute recovery window after a run. Spend time foam rolling, doing yoga or Pilates, or add in an extra day of rest or light cross-training.

Dehydration and electrolyte imbalance can cause cramping – and the last thing you want on top of pelvic pain is more cramps. Drink plenty of water and choose sugar-free electrolyte beverages (as long as the sugar substitute is not irritating to your stomach).

Take Care of Your Gut

If dysmenorrhea coincides with GI distress, avoid foods that can trigger stomach upset. Common culprits include dairy, cruciferous vegetables, beans, excessive caffeine, and sugary treats, although the exact irritants vary from individual to individual. Do not use this time to experiment with new fuel on your long runs – stick to the fuel that your gut has been trained to digest.

NSAIDs will relieve some pain, but they can also upset an empty stomach during exercise and cause GI distress. Be sure to eat a bland snack such as a banana or piece of toast before a run to keep your stomach settled. Be careful to not take too many NSAIDs (which trust me, is tempting when a normal dosage doesn’t make a difference), especially if GI distress is a symptom of your dysmenorrhea. You can take other types of painkillers such as acetaminophen, which won’t irritate your stomach as much.

Be Kind to Your Body

Heed your body’s signals. Let yourself miss a run if you need to. Some days, running will feel good, but some days you may find that the pain is too severe to run. Don’t force it. Take your runs at an easy to moderate effort and don’t force speedwork that week.

Most of all, keep things in perspective. Dysmenorrhea can strain one’s relationship with her body; I often felt angry at my body and emotional about the pain. One of the best things about running is that it can foster a positive relationship with your body. Even if you run less on your period because of the pain, focus on what your body can do in running.

Reader Interactions

Comments

I had some friends in high school/college that got really severe pain during their periods. Im grateful that mine have always been manageable. Im sorry you have had to deal with this but Im glad you have figured out a way to manage it and continue your running.

you know I relate to the pain and discomfort! I grew up with THE WORST most painful periods which including vomiting and fainting. Although I was always extremely regular, every 28 days was something I dreaded! thankfully after having my son, the pain became more manageable. while I do still have some months that aren’t great, only a handful of times have ever been as severe as before I had my son. I also find a mostly plant based diet to have worked wonders on the cramping as well. that said, I won’t run a race during my period and still watch to ensure I get it regularly after dealing with amenorrhea!

The nausea and dizziness are one of the worst parts! I honestly was sometimes relieved that I had long/irregular cycles (even though I knew they weren’t good) because it would give me a 40 or so day respite. I am so glad that yours became more manageable!

Oh Laura I am so sorry you had and have to deal with this! I cannot even imagine getting that sick and being in so much pain each and every month. I’m not surprised that running is helpful in reducing pain (is there nothing running can’t help?) but obviously you need to be able to stand upright first.
I’m so glad you’re opening up and talking about this and have the courage to share what I’m sure is a lot of painful memories. You are no doubt helping so many women who may be suffering from the same issue. I sincerely hope you have everything as much under your control as you can and are managing the pain and stress. You are such a beautiful person inside and out and definitely don’t deserve any of this!
A truly well written and heartfelt piece. Thank you for sharing your knowledge with us!

Alle, thank you so much for your kind and encouraging words! You are such an amazing and supportive friend. It is amazing how much running helped – exercise is said to work wonders for endometriosis, and I really think it does. I’m fortunate that my pain was never as severe as some cases I’ve heard of and I just hope other women find this helpful!

Oh wow. I don’t think I’ve ever read about someone discussing dysmenorrhea and running. Thank you for sharing your story. I’m sure it will help others out there. I’m glad you have running to help you cope with the symptoms.

I’m so glad you wrote about this!!! You’re going to help a lot of women out there, no doubt. I didn’t get painful periods but I’d often have ovarian cysts… even one of those kind that have solid things in it like hair and teeth. GROSSED ME OUT. K, that’s kinda embarrassing, but it’s true! I had a cyst the size of a grapefruit once when I was pregnant with a baby between Freddy and Katie and then it burst. It was SO PAINFUL.

Anyway, I think it’s good to talk about these things because it helps other women not feel so alone!

Thank you so much! I can’t imagine how painful those cysts much have been – I’m so sorry to hear that you had that happen, especially during a pregnancy. I agree – it is good to talk about these things, because it can feel so alienating at times when it seems like no one else has the same problem.

Thank you for sharing!! This might sound odd to say, but I am really happy to see/hear more open discussion about these matters. Maybe happy is not the right word. It just seems like we live in a culture and society that it is so taboo to discuss these situations. Hello?! This is our (women) world!!! I have been fortunate to not deal with dysmenorrhea, but my periods have become more painful (through cramps) as I have aged. Thank you for being so open on this matter!

Thank you so much, Aimee, for your support! It is sad how taboo it is – I would be so embarrassed when I’d show up to class sick (especially since I studied in a predominantly male field and would sometimes be the only woman or one of two) because I’d never want to say what was wrong. I’m sorry to hear your cramps have worsened – dysmenorrhea or not, cramps are NOT pleasant!

I used to have severe pain with my periods in high school. I distinctly remember being at my boyfriends house laying on his bed unable to move because I was in so much pain. Luckily the pain subsided with age but now that I have two babies, my periods are super heavy. No pain, though, thankfully. But gosh does it make running really un-fun.

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Welcome to Team Norris Running!

Hi, I'm Laura! I'm a distance runner, RRCA certified running coach, and outdoor enthusiast living in Northwest Indiana. Whether you want to run your first race or qualify for Boston, I'm here to help you achieve your personal best with training tips and individualized run coaching.